Cognitive behavioural therapy (CBT)

Cognitive behavioural therapy (CBT) is a therapeutic approach that focuses on the links between thoughts, feelings, physical sensations, and behaviour. It is often used to support people experiencing depression, anxiety, burnout, stress, or difficulties with sleep.

This page explains how CBT works, what is meant by "CBT-informed" therapy, and how CBT tools can be combined with mindfulness and other approaches within an integrative way of working.

How CBT can support you

Cognitive behavioural therapy looks at the patterns that tend to keep difficult feelings going. When someone is struggling, it can be easy to become caught in cycles such as:

  • Self-critical thinking and harsh inner dialogue

  • Withdrawing from people and activities once enjoyed

  • Struggling with energy, sleep, and motivation

  • Feeling stuck, hopeless, anxious, or overwhelmed

In CBT-informed work, these patterns are brought into focus so that new ways of responding can be tried out. This might include:

  • Identifying common thinking traps (such as all-or-nothing thinking or mind-reading)

  • Practising more balanced, compassionate self-talk

  • Planning small, achievable actions that support energy and a sense of purpose

  • Developing routines around sleep, rest, and movement that work for day-to-day life

CBT is often practical and structured, with an emphasis on noticing what happens between sessions as well as during them. Over time, the aim is to build understanding of what maintains low mood or anxiety and to develop tools that can be used in everyday situations.

CBT within an integrative approach

CBT can be used on its own, but many people find it helpful when it is combined with other ways of working. In an integrative approach, CBT tools sit alongside therapies that pay close attention to emotions, relationships, and past experiences.

An integrative, CBT-informed way of working may draw from:

  • CBT – practical tools to shift unhelpful thought and behaviour patterns

  • Mindfulness and ACT elements – present-moment awareness, values-based choices, and nervous system settling

  • Person-centred therapy – a non-judgmental, empathic relationship where you set the pace

  • Psychodynamic and relational work – exploring how earlier experiences shape current feelings and relationships

  • Solution-focused and parts-based work – identifying strengths, resources, and different "parts" that may be in conflict

This kind of integration allows room for both immediate coping strategies and deeper exploration. For example, someone might use CBT techniques to reduce self-criticism in the present, while also using relational or psychodynamic exploration to understand where harsh inner voices may have developed.

What to expect from CBT-informed sessions

Although CBT can vary depending on the person and the setting, there are some common features that are often present in CBT-informed sessions.

Initial conversation

The work typically begins with an initial conversation where you can:

  • Share a little about what has been happening

  • Talk about how low mood, anxiety, or stress are affecting day-to-day life

  • Discuss what you hope might be different

  • Ask questions about CBT, mindfulness, or longer-term psychotherapy

This early stage is often used to clarify what you would like from therapy and to check whether a CBT-informed approach feels suitable for your situation.

Early sessions

In early full sessions, there is usually time to slow things down and begin to build a shared picture of what you are facing. This may include:

  • How long difficult feelings have been around

  • Any recent changes, losses, or stresses

  • Sleep, energy, and concentration

  • Hopes, values, and areas of life you would like to focus on

Together, you and the therapist may talk through different therapeutic options, including structured CBT tools, mindfulness practices, and more exploratory work, and agree a focus that feels manageable.

Ongoing work

As the work continues, CBT-informed sessions often include:

  • Mapping patterns (triggers, thoughts, emotions, behaviours)

  • Learning grounding and breathing techniques to help when mood or anxiety spikes

  • Behavioural experiments to gently test out new ways of coping

  • Exploring earlier experiences and relationships that may shape how you see yourself now

  • Supporting the development of self-compassion, boundaries, and a sense of meaning

Sessions can be adapted depending on what is most helpful at the time. Some periods may focus more on active exercises and skills, while others may make more space for reflection and emotional processing.

CBT, mindfulness, and sleep

Many people experiencing depression, anxiety, or stress also struggle with disrupted sleep, early waking, or difficulty winding down at night. CBT and mindfulness can be combined to support both mood and sleep.

Within this kind of work, it is possible to:

  • Explore simple mindfulness practices to help calm a busy mind before bed

  • Use CBT-based strategies to work with worry, rumination, and unhelpful evening habits

  • Try out gentle routines that support better rest and recovery

Some approaches draw on ideas related to CBT for insomnia (often known as CBT-I), alongside mindfulness, to address both the thoughts and behaviours that affect sleep and the overall regulation of the nervous system.

For some people, it can be helpful to have sessions that focus particularly on mindfulness alongside more structured CBT-informed work, especially if anxiety and overthinking are prominent.

Why CBT-informed, integrative therapy?

Although this page focuses on CBT-informed work, CBT is rarely used in isolation in an integrative approach. An integrative perspective recognises that:

  • Practical tools can be useful, but people also benefit from being deeply heard and understood

  • Current difficulties often have roots in earlier experiences and relationships

  • Emotions, thoughts, bodily sensations, and behaviour all interact

CBT-informed, integrative therapy offers space to:

  • Understand patterns that keep depression, anxiety, or burnout in place

  • Experiment with new, more supportive ways of thinking and behaving

  • Explore the impact of past experiences on present-day struggles

  • Build a kinder, more compassionate relationship with yourself over time

This combination of structure and depth allows therapy to respond to different needs at different moments, whether the priority is immediate coping strategies, ongoing support for stress, or longer-term work on identity and self-worth.

Moving forward

If you are feeling stuck, exhausted, overwhelmed, or unlike yourself, CBT-informed, integrative therapy can offer a way of understanding what is happening and working with it more actively. By paying attention to patterns of thought and behaviour, and by bringing in mindfulness, relational awareness, and exploration of past experiences, CBT-informed work aims to support both day-to-day coping and longer-term change.